Provider Demographics
NPI:1164748869
Name:CATHOLIC CHARITIES - DIOCESE OF ROCKFORD, IL.
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES - DIOCESE OF ROCKFORD, IL.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIOCESAN DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:VONCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-399-4300
Mailing Address - Street 1:555 COLMAN CENTER DRIVE - PO BOX 7044
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61125
Mailing Address - Country:US
Mailing Address - Phone:815-399-4300
Mailing Address - Fax:815-399-6303
Practice Address - Street 1:102 S MADISON ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61104-1102
Practice Address - Country:US
Practice Address - Phone:815-965-0623
Practice Address - Fax:815-965-0628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL003972-12253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency